Organization
SPLIT MOUNTAIN EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
105 TAMIAMI TRAIL, PORT CHARLOTTE, FL 33953
(941) 629-1181
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
(973) 251-1132
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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